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HomeMy WebLinkAbout11-07-2006City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room MINUTES I. CALL TO ORDER Chair Jim Kelly called the meeting to order at 10:00 a.m. in the Council Conference Room located at Auburn City Hall, 25 West Main Street in Auburn. Chair Kelly and the following Board members were present: Chair Pro Tem Bud Larson (member-at-large), Member Roger Thordarson, Member Rich Wagner, and Member Bill Petersen. Also present were Board Attorney Joseph Beck and Board Secretary Danielle Daskam. II. APPROVAL OF MINUTES A. Minutes of the October 3, 2006 Reclular LEOFF Board Meeting Motion by Chair Pro Tem Larson, second by Member Petersen to approve the October 3, 2006 minutes as distributed. MOTION CARRIED. 5-0. At this time, the Board addressed a proposed amendment to the LEOFF Board Policies and Procedures Manual. Please refer to Item IV.D.1 of these minutes for further information. III. UNFINISHED BUSINESS A. Pending Disability Leave/Retirement Applications There was no pending disability leave/retirement request. B. Medical/Hearing/Vision Claims 1. Ray Nixon a. Request for reimbursement of tooth extraction (August 9, 2006) in the amount of $128.00. On September 5 and October 3, 2006, the Board tabled the claim pending receipt of proof of medical necessity for the dental treatment involving the tooth extraction. b. Request for reimbursement of dental surgical expenses (July 14, 2006) in the amount of $963.00. On September 5, 2006, the LEOFF Board tabled the claim pending receipt of proof of medical necessity for the LEOFF Board Minutes November 7, 2006 Page 1 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room dental/oral surgery including more specific information from Mr. Nixon's physician regarding the medical necessity for the treatment, including evidence of the cause and effect of the dental treatment on Mr. Nixon's current medical condition. On October 3, 2006, the LEOFF Board tabled Mr. Nixon's claims for dental treatments pending receipt of additional information regarding the cause and effect of the dental condition and treatment as it relates to his existing medical condition. Mr. Nixon submitted a statement dated September 29, 2006 from Dr. Merrill of the Enumclaw Medical Center in response to the Board's request. Motion by Member Wagner, second by Member Petersen to approve Mr. Nixon's claim up to the $1,200 limit of the new dental policy. Chair Kelly instructed the Board Secretary to ascertain any previous dental payments and whether Mr. Nixon is covered by any private dental insurance. MOTION CARRIED UNANIMOUSLY. 5-0. 2. Vern Fitzgerald Request for reimbursement of dental expenses incurred on July 12 and August 29, 2006 Dental Examination $156.90 Cleaning $ 75.00 Request for reimbursement of dental expenses incurred on September 1, 2006 in the amount of $260.00 On October 3, 2006 the LEOFF Board tabled Mr. Fitzgerald's claim pending further clarification. The Board Secretary transmitted information received telephonically from Mr. Fitzgerald regarding his claim. No other information was received. Motion by Member Petersen, second by Chair Pro Tem Larson to reimburse Mr. Fitzgerald for dental expenses in the amount of $491.90. LEOFF Board Minutes November 7, 2006 Page 2 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 -10:00 a.m. -Council Conference Room MOTION CARRIED UNANIMOUSLY. 5-0. IV. NEW BUSINESS A. Disability Leave/Retirement Applications 1. Rudy Peden Effective Date of Disability: October 12, 2006 Last Day of Service: October 11, 2006 On October 4, 2006, LEOFF Board Chair Jim Kelly tentatively approved disability leave for Rudy Peden effective October 12, 2006, subject to full Board review and approval. Mr. Peden's application for disability leave/retirement includes physicians' statements from Dr. Jeffrey Evans dated September 21, 2006 and Dr. Jeff Frankel dated September 29, 2006. Motion by Chair Pro Tem Larson, second by Member Wagner to concur with the Chair's action and approve disability leave for Rudy Peden effective October 12, 2006 with last day of service on October 11, 2006. MOTION CARRIED UNANIMOUSLY. 5-0. Chair Kelly presented the Board with a physician's statement from Mr. Peden's attending physician, Jeffrey M. Frankel, M.D. dated November 3, 2006 advising that Mr. Peden may return to work on November 10, 2006 without restrictions. Motion by Chair Pro Tem Larson, second by Member Wagner to return Rudy Peden to active duty status with the last day of disability on November 10, 2006 and first day of return to duty on November 11, 2006. MOTION CARRIED UNANIMOUSLY. 5-0. B. Appeals/Requests for Reconsideration 1. Alan Kosko June 5, 2006 request from Alan Kosko for pre-approval of dental treatment in the amount of $475.00. LEOFF Board Minutes November 7, 2006 Page 3 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room On October 3, 2006, the Board denied Mr. Kosko's claim. Mr. Kosko submitted a letter dated October 16, 2006 requesting reconsideration. Motion by Chair Pro Tem Larson, second by Member Petersen to grant reconsideration of Mr. Kosko's claim in light of the new policy under Section 8.02(D) and approve reimbursement of dental expenses in the amount of $475.00. MOTION CARRIED UNANIMOUSLY. 5-0. C. Medical/Hearing/Vision Claims 1. Russ Vandver Request for reimbursement in the amount of $20.11 per Regence Explanation of Benefits Statement #0617332432900 for medical services received on January 16, 2006 and processed by insurance on July 12, 2006. Motion by Chair Pro Tem Larson, second by Member Thordarson to approve Mr. Vandver's claim for reimbursement in the amount of $20.11. MOTION CARRIED UNANIMOUSLY. 5-0. The following claim from Mr. Vandver was added to the agenda during the meeting: Request for reimbursement in the total amount of $114.25 per Regence Explanation of Benefits Statement #0612332567500 and Regence Explanation of Benefits Statement #0607932404900. Motion by Chair Pro Tem Larson, second by Member Petersen to approve Mr. Vandver's claim in the amount of $114.25 MOTION CARRIED UNANIMOUSLY. 5-0. 2. Ray Nixon Request for reimbursement of vision expenses for lenses in the amount of $227.00. (Mr. Nixon had not received reimbursement for vision expenses in the last year.) Motion by Chair Pro Tem Larson, second by Member Petersen to approve reimbursement of vision expenses for Mr. Nixon in the amount of $225.00. LEOFF Board Minutes November 7, 2006 Page 4 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room MOTION CARRIED UNANIMOUSLY. 5-0. 3. Coy Franklin Grall Request for reimbursement of vision expenses for lenses and frames in the amount of $260.00. (Mr. Grall had not received reimbursement for vision expenses in the last year.) Motion by Chair Pro Tem, second by Member Petersen to approve reimbursement of vision expenses for Mr. Grall in the amount of $225.00. MOTION CARRIED UNANIMOUSLY. 5-0. 4. Bruce Caldwell Request for reimbursement in the amount of $49.40 per Regence Explanation of Benefits Statement #0625432647300 for medical services received on September 7, 2006 and processed by insurance on September 20, 2006. Motion by Member Thordarson, second by Member Petersen to reimburse the medical claim in the amount of $49.40. MOTION CARRIED UNANIMOUSLY. 5-0. 5. Ed Henderson Request for reimbursement of dental expenses incurred on September 13, 2006 in the amount of $124.45. Motion by Member Petersen, second by Chair Pro Tem Larson to approve Mr. Henderson's claim in the amount of $124.45 due to medical necessity. MOTION CARRIED UNANIMOUSLY. 5-0. D. Discussion (Discussion Item 1 was discussed immediately following the approval of minutes.) 1. Proposed Amendment to Policy Section 8.02(D) At the last Board meeting, the Board members suggested a proposed policy amendment to Section 8.02(D) as follows: D. Dental Expenses: LEOFF Board Minutes November 7, 2006 Page 5 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 -10:00 a.m. -Council Conference Room Tl~e-iJ~arrl rannnni~oc th~f fhor~ is 7r'~ in~r°r~.."":y a~~{~-rft~ +~ ed~c-at--ev+den~e~ rt--the -a~se~tier~--t-I~,a-~-peerdeeta l hnuitiM_~r-~_i-7v-JVIf in ~ ~nrirlo ~~~riot~~ of nthnr mn~_~La.~~~T~~~~6 s 1) Dental charges incurred by a member who sustains an accidental injury to his or her teeth shall be paid. Thc~ nv_p°ci~r°~.° of ©~~'~~T~--E~ef-~e~-a~--{~~--E~ttCtYF-~~-f 3-}-----No-r~Qre--than--two-42-}-deb---~ea~ai~q-s-ea~eh--y~~r wifl--be nn»nrn~^I fnr w mamhclr linlcin~c I~_r~ TJ-_QeTelin ed I-r'rri'-clime ~vvcrc.. ~r-rcr r-~ca--r-I Tc~.T r ~u~, r ~ "~'v I rrv , d+ssc-r-et+a ~--$f-t-k+e- 8oe~f; -t kit-a--r~+o re-fregoe rite a+~} n g sel~ed~+le_ ~s---~ed+celly---+~ecessa~y-~n-a-pa-rtisular-tease--or 4~--~e~ ta-l-expenses-ion gyred-by-a-r-~~er~ be r--fe r-reef+ne-d ee#a l ,a-nt-i-per-Ee~ental-were-r~t~sf bn-,med7ical~-y-news-sari---ate recceive-pr~ 2~) No dental expenses incurred by a member for dental services or work which is purely cosmetic in nature will be approved or paid, except in unusual circumstances, and then only with the prior written approval of the Board and based upon medical necessity. 36) Dental expenses incurred by a member for teeth - whitening will not be approved. 4~) Dentures may be approved; however, prior authorization by the Board is required. Dentures will be reimbursed to a maximum amount of $1,387.00 per plate. Dental related expenses up to an annual amount of Lollar amount to be determined -initial suggestion was $1,000 will be covered. Dental expenses above this amount will be the responsibility of the member. The annual term runs from Janua~ 1 of each calendar year to December 31 of the same year. Board members reviewed a survey of other LEOFF Boards' dental benefits and some sample policies. Chair Kelly reported that he averaged the amount of the dental benefit for those Boards that provide a dental benefit. There were thirty-four Boards surveyed, nineteen of which provided a dental benefit. Chair Kelly omitted the low and high amounts from the sample resulting in an average annual benefit of $1,300.00. LEOFF Board Minutes November 7, 2006 Page 6 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room Member Wagner suggested that the Board consider the number of Boards that do not provide any dental benefit and reduce the suggested annual dental benefit to $1,000. Board members discussed options for providing dental insurance for retirees and the proposed amendment to Policy Section 8.02(D). Motion by Member Petersen, second by Member Thordarson to adopt the following amendment to Policy Section 8.02(D) so that the section reads as follows: D. Dental Expenses: 1) Dental charges incurred by a member who sustains an accidental injury to his or her teeth shall be paid. 2) No dental expenses incurred by a member for dental services or work which is purely cosmetic in nature will be approved or paid, except in unusual circumstances, and then only with the prior written approval of the Board. 3) Dental expenses incurred by a member for teeth whitening will not be approved. 4) Dentures may be approved; however, prior authorization by the Board is required. Dentures will be reimbursed to a maximum amount of $1,387.00 per plate. 5) Dental related expenses, not otherwise addressed in Section 8.02(D) herein, up to an annual amount of $1,200 will be covered. The annual term runs from January 1 of each year to December 31 each year. 6) No payment will be authorized without proof that the member has first submitted the claim for payment to the member's outside dental insurance. MOTION CARRIED UNANIMOUSLY. 5-0. 2. Election of Fire LEOFF Board Representative Board Secretary Daskam reported that requests for nominations were mailed October 23, 2006. Nominations were due by 5:00 p.m. on November 6, 2006. One nomination for the fire LEOFF Board representative was received from Bill Petersen. According to Board policies, balloting is not required when only one person submits a nomination. Therefore, Bill Petersen is elected as the fire LEOFF Board representative for the term ending December 31, 2008. LEOFF Board Minutes November 7, 2006 Page 7 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday November 7, 2006 - 10:00 a.m. -Council Conference Room V. ADJOURNMENT There being no further business to come before the Board, the meeting adjourned at 11:00 a.m. +~. APPROVED THE S DAY OF DECEMBER, 2006. ~,~~ ~~. Jim elly, Chair ~ -~~~ ~- Danielle Daskam, Secretary LEOFF Board Minutes November 7, 2006 Page 8